实用口腔医学杂志
實用口腔醫學雜誌
실용구강의학잡지
JOURNAL OF PRACTICAL STOMATOLOGY
2014年
5期
684-688
,共5页
丁明超%Ujjwal Koiral%王维戚%石晋%蔡宏伟%薄斌%赵晋龙%马秦
丁明超%Ujjwal Koiral%王維慼%石晉%蔡宏偉%薄斌%趙晉龍%馬秦
정명초%Ujjwal Koiral%왕유척%석진%채굉위%박빈%조진룡%마진
重症%头颈部%多间隙感染%回顾性分析
重癥%頭頸部%多間隙感染%迴顧性分析
중증%두경부%다간극감염%회고성분석
Life threatening%Head and neck%Multi-space infection%Retrospective analysis
目的：回顾总结重症颌面部间隙感染的治疗经验。方法：分析32例重症颌面颈部间隙感染患者的基本信息、治疗过程及转归，总结治疗经验。结果：2007-01～2013-01收治32位患者，病例数逐年增加，平均年龄57．71岁。11例（34．37％）患者出现呼吸道危象；19例（59．3％）伴发全身系统性疾病。8例患者转入胸外科及呼吸科，1例患者死亡，23例好转或治愈。脓送检率96．87％，检出率37．50％。培养结果以链球菌为主，其它可见葡萄球菌、铜绿假单胞菌、粪肠球菌、产黑素普雷沃菌、干燥奈瑟球菌、热带假丝酵母菌。结论：重症间隙感染患者近年明显增加。建议治疗措施：①保证呼吸道通畅及生命安全；②尽早手术切开引流，去除病灶；③降糖、降压、降温、镇痛、营养支持补液等多学科协同治疗；④全身抗感染治疗。
目的：迴顧總結重癥頜麵部間隙感染的治療經驗。方法：分析32例重癥頜麵頸部間隙感染患者的基本信息、治療過程及轉歸，總結治療經驗。結果：2007-01～2013-01收治32位患者，病例數逐年增加，平均年齡57．71歲。11例（34．37％）患者齣現呼吸道危象；19例（59．3％）伴髮全身繫統性疾病。8例患者轉入胸外科及呼吸科，1例患者死亡，23例好轉或治愈。膿送檢率96．87％，檢齣率37．50％。培養結果以鏈毬菌為主，其它可見葡萄毬菌、銅綠假單胞菌、糞腸毬菌、產黑素普雷沃菌、榦燥奈瑟毬菌、熱帶假絲酵母菌。結論：重癥間隙感染患者近年明顯增加。建議治療措施：①保證呼吸道通暢及生命安全；②儘早手術切開引流，去除病竈；③降糖、降壓、降溫、鎮痛、營養支持補液等多學科協同治療；④全身抗感染治療。
목적：회고총결중증합면부간극감염적치료경험。방법：분석32례중증합면경부간극감염환자적기본신식、치료과정급전귀，총결치료경험。결과：2007-01～2013-01수치32위환자，병례수축년증가，평균년령57．71세。11례（34．37％）환자출현호흡도위상；19례（59．3％）반발전신계통성질병。8례환자전입흉외과급호흡과，1례환자사망，23례호전혹치유。농송검솔96．87％，검출솔37．50％。배양결과이련구균위주，기타가견포도구균、동록가단포균、분장구균、산흑소보뢰옥균、간조내슬구균、열대가사효모균。결론：중증간극감염환자근년명현증가。건의치료조시：①보증호흡도통창급생명안전；②진조수술절개인류，거제병조；③강당、강압、강온、진통、영양지지보액등다학과협동치료；④전신항감염치료。
Objective:To review the treatment of life threatening head and neck space infection.Methods:Retrospective was con-ducted to analyse the patient characterization,signs and symptoms at the time of presentation,presence of concomitant systemic co-morbidities,treatment,prognosis and bacteriology.Results:32 patients from 2007.01 to 2013.01(mean age was 57.71 years)were included.The cases were increased year by year.1 1 (34.37%)patients had breathing difficulty requiring tracheostomy and 19 (59.3%)had concomitant systemic comorbidities.23 cases recovered completely,8 with severe mediastinal infection were trans-ferred to the department of thoracic surgery or the department of respiratory medicine.1 patient died.Pus submission rate was 96.87%,the bacteria detection rate was 37.50%.Pus culture showed mixed infection dominated by streptococci.Staphylococcus au-reus,pseudomonas aeruginosa,enterococcus faecalis,prevotella and neisseria were detected.Conclusion:Annually incidence of life threatening head and neck space infection is increasing.Treatment of the infection should include:①Ensuring the airway patency;②Surgical incision and drainage as early as possible;③ Hypoglycemic control,maintenance of hemodynamic,nutritional support,and multi-disciplinary approach are the key points in the management of such infections;④ Systemic antibiotics.
